MEDICARE: OKLAHOMA GASTROENTEROLOGY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1073326203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OKLAHOMA GASTROENTEROLOGY CENTER LLC

Provider Business Mailing Address
First Line	:	15516 LAGUNA DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-8925
Country	:	US
Telephone Number	:	405-210-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	13301 N MERIDIAN AVE STE 501
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9368
Country	:	US
Telephone Number	:	405-210-7000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ARUN SACHDEV
Credential	:	MD
Telephone Number	:	405-252-9820

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	06/24/2025

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